| NPI | 1326103193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN MOORE Business Manager 847-510-5625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2020-08-22 |